Organization Name: | DLP TWIN COUNTY PHYSICIAN PRACTICES LLC |
NPI Number: | 1497020226 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JESS N JUDY (PRESIDENT) |
Mailing Address: | 702 Pine St Hillsville |
State: | VA US |
Postal Code: | 243431405 |
Phone Number: | 2767284311 |
Fax Number: | 2767280901 |
NPI Enumeration Date: | 03/12/2012 |
NPI Last Update Date: | 05/03/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |